Assessment of Impact of HLA Type on Outcomes of Allogeneic Hematopoietic Stem Cell Transplantation for Chronic Lymphocytic Leukemia

作者：Hill Brian T; Ahn Kwang Woo; Hu Zhen Huan; Aljurf Mahmoud; Beitinjaneh Amer; Cahn Jean Yves; Cerny Jan; Kharfan Dabaja Mohamed A; Ganguly Siddhartha; Ghosh Nilanjan; Grunwald Michael R; Inamoto Yoshihiro; Kindwall Keller Tamila; Nishihori Taiga; Olsson Richard F; Saad Ayman; Seftel Matthew; Seo Sachiko; Szer Jeffrey; Tallman Martin; Ustun Celalettin; Wiernik Peter H; Maziarz Richard T; Kalaycio Matt; Alyea Edwin; Popat Uday; Sobecks Ronald; Saber Wael

来源：Biology of Blood and Marrow Transplantation, 2018, 24(3): 581-586.

DOI：10.1016/j.bbmt.2017.10.015

• CLL
• HLA
• Allogeneic transplantation

Chronic lymphocytic leukemia (CLL) is a common hematologic malignancy with many highly effective therapies. Chemorefractory disease, often characterized by deletion of chromosome 17p, has historically been associated with very poor outcomes, leading to the application of allogeneic hematopoietic stem cell transplantation (allo-HCT) for medically fit patients. Although the use of allo-HCT has declined since the introduction of novel targeted therapy for the treatment of CLL, there remains significant interest in understanding factors that may influence the efficacy of allo-HCT, the only known curative treatment for CLL. The potential benefit of transplantation is most likely due to the presence of alloreactive donor T cells that mediate the graft versus -leukemia (GVL) effect. The recognition of potentially tumor-specific antigens in the context of class I and II major histocompatibility complex on malignant B lymphocytes by donor T cells may be influenced by subtle differences in the highly polymorphic HLA locus. Given previous reports of specific HLA alleles impacting the incidence of CLL and the clinical outcomes of allo-HCT for CLL, we sought to study the overall survival and progression-free survival of a large cohort of patients with CLL who underwent allo-HCT from fully HLA-matched related and unrelated donors at Center for International Blood and Marrow Transplant Research transplantation centers. We found no statistically significant association of allo-HCT outcomes in CLL based on previously reported HLA combinations. Additional study is needed to further define the immunologic features that portend a more favorable GVL effect after allo-HCT for CLL.

• 出版日期2018-3